Know Your Horse in Health

Components of your regular horse exam should include listening for normal intestinal sounds, performing a skin pinch test to evaluate hydration, and feeling the feet to detect heat and inflammation, among other assessments.

Photo: Alexandra Beckstett, The Horse Managing Editor

Examine your horse's vital signs, body, and behavior on a regular basis to become a more active participant in his care.

One of my clients called me recently with an after-hours emergency. Her horse had a poor appetite, seemed depressed, and had been lying down more than normal. She thought the problem might be colic, and she was hopeful that a shot of flunixin meglumine (Banamine) would resolve it. She was calling me to determine the best approach to take. I explained to her that many different ailments could cause the signs she described. Whether the Banamine would help depended on the diagnosis, and I would need to examine the horse to make one.

This owner had recently attended a workshop I had given, during which I taught attendees how to assess their horses in health and how to perform a basic physical examination. I asked her to describe the results of her assessment. Given the specific information that this horse owner provided to me right then--­abnormally high heart and respiratory rates, moderate fever, and abnormally red mucous ­membranes--I suggested she not try to treat the problem herself and, instead, bring the horse to our hospital immediately for diagnosis and treatment.

Upon arrival, the horse was obviously very ill. I took a careful history, performed a thorough physical examination, and ran various diagnostic tests to determine the horse was suffering from an inflammatory condition of the small intestine. We treated the horse aggressively over several days, and he recovered completely. While the hospital stay was not inexpensive, the total cost of veterinary care was probably far less than it would have been, had the owner tried to treat the horse herself first, or even if I had made the long drive to her stable first (only to determine when I arrived that the horse needed hospitalization to survive). These alternatives also would have delayed diagnosis and treatment. The outcome was good in part because my client knew her horse in health and was able to recognize signs of illness. She could perform a basic physical examination competently, and she knew how to organize her results and share them with me.

By sharpening your own assessment skills and sharing your observations with your veterinarian, you can become a more active participant in your horse's care. This improved awareness can help you take your horse's management to a whole new level.

The Whole Horse Exam

I encourage horse owners to learn a skill set that I call "The Whole Horse Exam." During this exam they measure the basic vital signs of temperature, pulse, and respiration, along with other useful health indicators.

This exam is designed as a drill so owners can recall and perform it easily and record the results efficiently. Ideally, horse owners should be as comfortable performing the exam on their horses as they are grooming them or picking their hooves. When you want to generally assess your horse's health status, simply perform this exam. By practicing it on your horses while they are healthy, you should be better equipped to perform it confidently when you suspect there's a problem.

Sharing your findings (using a form such as the Horse Health Parameters Form) with your veterinarian can help him or her determine the problem's nature and severity and advise you properly.

Preparation

First you must learn or review very basic equine anatomical landmarks (see ­TheHorse.com/30201). By knowing the names of major anatomic structures, you can communicate more effectively with your veterinarian. To conduct the exam, you will need a few supplies, including a halter and lead rope, a quality LED headlamp (for late-night emergencies), a mercury thermometer with a string and alligator clip (my personal preference over a digital thermometer, which must be held in place), and a stethoscope, if available.

You'll also need a supply of disposable latex gloves. Be sure to wear these if you put your hands in a sick horse's mouth as a safeguard against exposure to the rare but fatal disease rabies. Changing/­disposing of gloves after handling a sick horse also helps prevent disease spread to other ­horses.

When examining your horse, set yourself up for safety and success. Work in a flat, safe place with good light and footing. A horse's stall is usually best, as he is accustomed to it and usually most calm there. Always put a halter and lead rope on your horse while performing the exam. It can be helpful to have an experienced horse handler available, especially when assessing a distressed horse, but is not a necessity if you have taught your horse to accept the exam willingly by practicing good ­horsemanship.

Procedure

Start your exam by watching the horse from a distance to assess his demeanor and attitude. Take note of body language: Does the horse seem engaged or withdrawn? Note the environment: Is there a normal amount of manure and urine in his stall? Has the horse consumed the expected amount of hay and water? Now study your horse’s reaction as you ­approach and halter him: Is he behaving as he normally does?

Standing in front, behind, and then on the left and right sides, visually examine the horse's body and legs, top to bottom, for any abnormalities, swellings, or asymmetries. Objectively consider the horse’s body condition, skin, muscling, mane, tail, and coat, and pay particular attention to the legs and hooves. Any asymmetry of the legs, body, or muscling might indicate injury or a musculoskeletal or neurologic condition, among others. Also compare right and left eyes and facial symmetry. Does one side of the face droop more than the other? Does one eye seem more sunken?

Now measure his vital signs and other health parameters, as described in the chart below. First, after moving along the near side of the horse back toward the tail area, insert a shaken-down thermometer, and clip it to the horse's tail. Return to the horse's head, and assess his gum color and capillary refill time. Pinch the skin on the horse’s left shoulder to assess his ­hydration.

If you have a stethoscope handy, place it just behind the elbow on your horse's left side, where the girth lies, to listen to the heart. Otherwise, use your finger to take his pulse at the lingual artery that crosses under the jaw (as shown on the cover). Determine respiratory rate by placing the stethoscope head at the lowest part of the neck below the throat or by watching the horse's abdomen move. Assess the horse's gut sounds. First listen to the left upper and lower abdomen, then move around the rear of the horse and listen to the right upper and lower abdomen.

Now run your hands over the entire left front limb, from the forearm to the foot, noting any swelling, heat, or a painful reaction from the horse (signs of pain vary from horse to horse, but look for any abnormal posture, movement, expression, or behavior). Feel the hoof for digital pulse and heat (both are abnormal). Pick the foot up, inspect the sole, and again run your hands over the structures of the raised limb, especially feeling for heat and swelling. Gently place the limb back on the ground. Cover as much of the horse as you can with your hands as you move rearward. Repeat the procedure for left hind, right hind, and right forelimb. Finally, lead the horse forward a few steps and turn him in a small circle to both the left and right. This can help you detect stiffness, lameness, or incoordination. At this point, remove the thermometer and note the rectal temperature.

Discuss the whole horse exam with your veterinarian when he or she performs routine work on your horses. This is an opportunity to communicate your desire to play a more significant role in monitoring his health. Your veterinarian might recommend that you provide different information from what I suggest here, or he or she might have different preferences for how you perform the exam. The important thing is that you start the ­dialogue.

Practice

Perform this basic exam daily on your horse for a week, and record your results each time. This will help you learn the individual elements and the flow of the process. By becoming familiar with what is normal for your horse, you will be better at recognizing abnormal. And by recording the results of your assessment multiple times, you will establish an average baseline to which you can compare results when your horse seems out of sorts. Consider these practice sessions as yet another opportunity to reinforce your relationship with your horse and to train him to accept all elements of the ­procedure.

Ultimately, your horse should calmly allow you to raise his tail and insert a thermometer and quietly accept you handling his mouth and touching around the eyes, ears, sheath, or udder. If the horse resists any element, take the time to teach him compliance. Your veterinarian might suggest tricks to make these assessments easier.

Once you become confident in completing the drill, practice it periodically to update your horse's "normal values" and to refresh you and your horse's memory on the process. If you ever perceive a problem with your horse, you will know how to gather the information you and your veterinarian need quickly. Your horse will also be accustomed to the procedure and be compliant for the exam.

Take-Home Message

Equine veterinarians' extensive training and large case loads arm them with many reference points for comparing patients and recognizing subtle details not visible to the untrained eye. But you know your own horse best--what is "normal" for him and what is not. By taking extra time now to know your horse in health and to learn and practice the whole horse exam skills, you will be better prepared to notice any equine health issues that arise. Expand your knowledge, hone your powers of observation, and share your findings with your veterinarian to provide the best care possible for your horses.